Role of anticholinergic medications in patients requiring long-term antipsychotic treatment for psychotic disorders
Question 6: In individuals with psychotic disorders (including schizophrenia) who require long term antipsychotic treatment, are anticholinergic medications more effective in preventing or reducing extrapyramidal side-effects and/or improving treatment adherence than placebo/treatment as usual?
- Population: people with psychotic disorders, including schizophrenia
- Interventions: anticholinergic medications in patients treated with antipsychotics
- Comparison: placebo or antipsychotic treatment alone
- Outcomes:
- adverse effects of antipsychotic treatment
- treatment adherence.
Recommendation(s)
Anticholinergics should not be used routinely for preventing extrapyramidal side-effects in individuals with psychotic disorders (including schizophrenia) treated with antipsychotics.
Strength of recommendation: STRONG
Short-term use of anticholinergics may be considered only in individuals with significant extrapyramidal side-effects when dose reduction and switching strategies have proven ineffective, or when these side-effects are acute or severe.
Strength of recommendation: STANDARD
Anticholinergics should not be prescribed to pregnant women for the extrapyramidal side-effects of antipsychotic drugs except for acute short-term use.
Strength of recommendation: STRONG